Marty Makary resigned Tuesday as commissioner of the U.S. Food and Drug Administration amid growing tensions within the Trump administration over vaping policy, abortion medication oversight and broader public health controversies.
Multiple reports, including from The New York Times, said Makary stepped down as President Donald Trump was preparing to remove him from the position. The resignation marks another high-profile departure from the administration during a turbulent year for federal health agencies.
According to The Times, Makary’s most significant clash with the White House centered on fruit-flavored e-cigarettes. Makary reportedly opposed expanding access to the products because of concerns they could appeal to children and teenagers. However, the FDA quietly issued a policy Friday making it easier for companies to market flavored vaping products after pressure from the White House.
The dispute highlighted a broader divide between Makary and other administration officials over regulatory priorities. Republicans had also criticized him for failing to move quickly on promises to review the safety of the abortion medication mifepristone. Trump and several Republican allies have urged the FDA to reverse a Biden-era policy that allowed doctors to prescribe the drug through telemedicine appointments.
Makary also faced backlash from public health experts after the FDA released a memo claiming deaths were linked to COVID-19 vaccines without providing supporting evidence. Critics further questioned his leadership after he loosened restrictions on peptides, compounds that remain largely unproven medically but have gained popularity among supporters of Health Secretary Robert F. Kennedy Jr. and the Make America Healthy Again movement.
Diana Zuckerman, president of the National Center for Health Research, warned that replacing Makary with a more politically aligned figure could further destabilize the agency.
“He has offended almost everyone involved in FDA issues, which is not easy to do,” Zuckerman told The Times. “But it would still be a disaster if he is replaced by someone who appeals primarily to tobacco companies, anti-abortion activists” and pharmaceutical companies.
Makary’s tenure was also shaped by significant staffing turmoil inside the FDA. Early in his leadership, Kennedy and Elon Musk — then overseeing the Department of Government Efficiency initiative — pushed major budget reductions and workforce cuts. Some layoffs affected employees responsible for reviewing surgical devices, inspecting food manufacturers and monitoring drug safety. While several employees were later rehired, another wave of cuts reportedly eliminated roughly 4,000 positions, or about one-fifth of the agency’s workforce.
The administration has named Kyle Diamantas, the FDA’s top food official, as acting commissioner, according to The Guardian. It remains unclear whether Trump will nominate Diamantas permanently.
Trump addressed Makary’s departure briefly Tuesday, telling reporters the outgoing commissioner is “a great guy.”
“He’s a great doctor and he was having some difficulty, but he’s going to go on and he’s going to do well,” Trump said. “Everybody wants that job.”
